Sept. 18, 2000 -- Eighty-two year-old Doris Trautner of National Park, N.J., remembers waking up from her triple cardiac bypass operation very well. "The very first thing I remember is the nurses telling me to get up," Doris tells WebMD. "I thought it was unbelievable; I mean, I was in such pain, and I was attached to so many monitors and things. But, they got me up and made me walk down the hall. That was the beginning of their emphasis on exercise, and they're still at it. Every time I see my cardiologist, he asks me how much I'm walking. Not if I'm walking at my age, but how much!"
Moderate physical activity, such as walking or gardening, improves the risk of heart disease even in those who already have it, according to two studies published in the Sept. 19 issue of Circulation: Journal of the American Heart Association. Both studies also report that exercise improves the risk of heart disease in people who have been inactive in the past.
"Ours is really a 'good news' kind of study," Douglas Seals, PhD, tells WebMD. "We looked at the ability of arteries -- the blood vessels that carry blood from the heart -- to expand, which is something they need to do in response to things like exercise. We found that in young, middle-aged, or older men who ran, the vessels retained their ability to expand. In sedentary people, this ability declined with age; but, with very moderate training -- that is, walking for about 45 minutes five or six times a week -- the ability actually came back."
"This happened no matter how long people had been sedentary. So this is really great! Not only can we avoid one of the consequences of aging that probably is fundamentally related to cardiovascular disease by continuing to exercise, we can actually reverse the situation by beginning moderate exercise," says Seals. "It's a win-win situation."
Seals, who is a professor of kinesiology and applied physiology at the University of Colorado at Boulder and senior author of one of the studies, says that the exercise program the older men he studied engaged in can be done at home by anyone. "We always worry about interventions for cardiovascular disease and their ability to translate into 'real life,'" he says. "This exercise program involved simply walking at a moderate pace; so its something virtually anyone can do anywhere, once they've obtained clearance from their doctor."
The second study involved analysis of data from the British Regional Heart Study, a very large study following more than 7,000 British men to evaluate the development of coronary heart disease among them and factors related to its development. Coronary arteries carry blood to the heart, and when they get diseased, the heart gets insufficient amounts of blood. This leads to coronary heart disease and myocardial infarction (heart attacks).
Lead author S. Goya Wannamethee, PhD, and colleagues write, "We examined the relation between physical activity and changes in physical activity over 5 years of follow-up in older men with established coronary heart disease and assessed the effects of the common types of physical activity (walking, gardening, and sport) on mortality rates." Wannamethee is with the department of primary care and population sciences at the Royal Free and University College Medical School in London.
The investigators found that in men with established coronary heart disease, light and moderate levels of physical activity -- even when taken up later in life -- were associated with a significant reduction in risk of death from cardiovascular disease in addition to lower death rates from all causes. This benefit was seen in men younger than 65 years of age and in those older than 65. "Benefit was achieved by light forms of physical activity, for example, walking, gardening and recreational activity," write the authors. "Even those with severe breathlessness achieved significant benefit from these lighter activities."
"These two studies provide further support that physical activity translates into healthier blood vessels and a lower risk of cardiovascular disease," says Roger Blumenthal, MD, director of preventive cardiology at Johns Hopkins, who commented on the studies for WebMD. "We also know that even in people with other diseases, not just cardiovascular disease, exercise provides tremendous benefits. People with high blood pressure, diabetes, and high cholesterol also reap benefits from moderate exercise, which is one of the cornerstones of management for these conditions."
According to Blumenthal, vigorous exercise is great, but moderate exercise works just fine. "The latest guidelines on physical activity from the National Heart, Lung and Blood Institute indicate that you really get the most bang for your buck with moderate activity. People who engage in this level of activity do almost as well as those who exercise more strenuously in terms of risk reduction and improving their profiles of cholesterol, for example. So, if you want to be competitive or really fit, great," he says. "But, if your objective is health, you can do so and still have a life."